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Joint Strategic Needs Assessment Devon Overview 2012

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Joint Strategic Needs Assessment Devon Overview 2012 Joint Strategic Needs Assessment Devon Overview Understanding the Different Needs Across the Life Course in Devon EXECUTIVE SUMMARY This overview was produced to provide a summary of health and wellbeing needs across the Devon County Council area. It contains a range of information about health and the factors that influence the health of the population from a range of sources. The report is shaped by the life course approach and groups topics in relation to childhood, adulthood and older people, whilst acknowledging there is considerable overlap between groups. Listed below is a selection of themes emerging from the assessment which have a notable impact on the health of the population in Devon. A common factor with these themes is that they cannot be addressed by a single organisation alone, and represent areas where a joint partnership approach is necessary. 1 INTRODUCTION This overview has been produced to provide a summary of health needs data across the Devon County Council area. It gives a broad range of information about health and factors which influence the health of the population of Devon to help inform and shape the planning and commissioning of services. It draws information from a number of different sources, some of which are produced specifically for the Joint Strategic Needs Assessment and others are documents which support the process from within partner organisations. These sources include the Devon Joint Strategic Needs Assessment town profiles and the topic pages on the Devon Health and Wellbeing website, economic data from Devonomics (the local economic assessment), the Adult Social Care Market position statement, the Annual Public Health Report and other more detailed Joint Strategic Needs Assessments and Health Needs Assessments. The life course approach The public health strategy for England, Healthy Lives, Healthy People, published in 2010 proposed that a life course approach is taken in tackling the wider social determinants of health. The Marmot review highlights the importance of childhood experiences in reducing health inequalities across the life course. This review highlights that the foundations for virtually all aspects of human development are laid in early childhood(Marmot Review 2010, www.marmotreview.org.) These experiences can have lifelong impacts on health and wellbeing and therefore to start to reduce inequalities, the social gradient in children‟s access to positive early experiences needs to be addressed. The life course approach aims to Page 1 of 56 understand and address how these experiences in childhood and adolescents influence socio economic position and risk of disease later in life. This summary is largely grouped around different life course stages in Devon. Over the life course the health and wellbeing needs and requirements of the population change. Many needs are relevant in just one stage of the life course, where as others are relevant over many stages. This makes presenting information over the stages of the life course complicated. To reflect this, the report groups information in to three wider groups of children and young people, adults, and older people, grouping these needs according to where the impact is judged to be the greatest. Outcomes frameworks The NHS Outcomes Framework for England was first published in December 2010 and sets out the outcomes and corresponding indicators that will be used to hold the NHS to account for the outcomes it delivers through commissioning health services. The NHS Outcomes Framework for 2012/13 was published in December 2011 and includes 60 indicators across five domains. The Adult Social Care Outcomes Framework was first launched in March 2011, following consultation on a broader, more transparent and outcome-focused approach to presenting information on what adult social care has achieved. It is a set of outcome measures, which have been agreed to be of value both nationally and locally for demonstrating the achievements of adult social care. The Public Health Outcomes Framework for England, 2013-2016 was published in January 2012 by the Department of Health. This follows a consultation paper on the proposed Public Health Outcomes Framework which was published in December 2010. The framework sets the context and „strategic direction‟ for the new public health system with the vision of „improving and protecting the nation‟s health while improving the health of the poorest fastest‟. The framework has two high-level outcomes which underpin the vision: Increased healthy life expectancy Reduced differences in life expectancy and healthy life expectancy between communities (including differences between and within local authorities). It is proposed that progress on relevant measures within these frameworks should be built into the Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy, and therefore inform the work and priorities of Health and Wellbeing Boards. Equality and Diversity The Equality Act is a piece of legislation that protects us from unfair treatment because of „the way we are‟ - that is something we cannot control such as our age or sex. On 1st October 2010 the majority of the Act came into effect. The Act replaced all previous equality legislation, bringing everything together under one single Act including the Disability Discrimination Act, Sex Discrimination Act, Race Relations Act and many other Regulations and Acts and some new additional ones. It is against the law to discriminate against someone because of any of the following protected characteristics (whether knowingly or not) – age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Page 2 of 56 The Devon Joint Strategic Needs Assessment aims to help ensure that health and social care services do not discriminate against any of these nine groups and where possible help to identify populations and any problems that may be experienced in accessing services. 2 DEMOGRAPHICS Population Devon has an older population profile than nationally, with particular peaks in those aged 60 to 64 years of age, reflecting significant in-migration in these age groups, and those aged 85 years and over, reflecting an ageing population and longer life expectancy (Figure 2.1). The proportions of those aged 20 to 39 and those under 10 years are below the national average, particularly in those aged 25 to 34 where there is significant out-migration from Devon. This overall pattern is even more marked in areas of East Devon and South Hams, whilst the population in Exeter is more similar to the national average, but with an increased young adult population due to the university. The 2008-based population projections published by the Office for National Statistics (ONS) in 2010, predicted a 20% increase in the Devon population from 746,800 in 2008 to 898,500 in 2033. Whilst modest growth is expected in those aged under 60, population growth is set to be greatest in older age groups (Figure 2.2). This includes a 28% increase in those aged 60 to 69, a 58% increase in those aged 70 to 79, a 92% increase in those aged 80 to 89 and a 233% increase in those aged 90 and above. The publication of the 2011 Census data will be used for estimating and projecting populations in the coming years. Figure 2.1: Structure of the mid-year 2010 population in Devon compared with England and Wales 85+ 80-84 75-79 70-74 Male Female 65-69 60-64 55-59 50-54 45-49 40-44 Age Group 35-39 30-34 25-29 20-24 15-19 England & Wales 10-14 average 5-9 0-4 5% 4% 3% 2% 1% 0% 1% 2% 3% 4% 5% Percentage of Population Source: Mid-Year Population Estimates, Office for National Statistics licensed under the Open Government Licence v.1.0 Page 3 of 56 Figure 2.2: The projected demographic change in the population structure of Devon, persons aged 60 and over by age group, 2008 to 2033 400,000 350,000 26,300 300,000 90 and over 78,800 250,000 80 to 89 7,900 200,000 41,000 107,900 70 to 79 150,000 68,400 100,000 128,200 60 to 69 50,000 100,400 0 2008 2013 2018 2023 2028 2033 Source: Sub-national population projections, Office for National Statistics licensed under the Open Government Licence v.1.0 NHS Devon and Devon County Council both make use of MOSAIC to gain an additional insight in to the types of people who live in Devon. MOSAIC is a geodemographic profiling tool which classifies postcode areas or households into 15 groups based on characteristics and behaviours of households. The groups can be broken down further which enables areas more susceptible to particular health risks to be identified and targeted with preventative work. The summary below shows the proportions of the Devon population in each MOSAIC group, compared to the national profile. Page 4 of 56 Figure 2.3: Devon and national population by MOSAIC group Devon and National Population Categorised by MOSAIC Groups 5% A Residents of isolated rural communities 21% 5% B Residents of small and mid-sized towns with strong local roots 19% 4% C Wealthy people living in the most sought after neighbourhoods 1% 4% D Successful professionals living in suburban or semi-rural homes 8% 9% E Middle income families living in moderate suburban semis 6% 8% F Couples with young children in comfortable modern housing 2% 7% G Young, well-educated city dwellers 5% 4% H Couples and young singles in small modern starter homes 3% 9% I Lower income workers in urban terraces in often diverse areas 3% 6% J Owner occupiers in older-style housing in ex-industrial areas 7% 12% K Residents with sufficient incomes in right-to-buy social houses 9% 9% L Active elderly people living in pleasant retirement locations 10% 3% M Elderly people reliant on state support 4% 9% N Young people renting flats in high density social housing 1% % of National population 5% % of Devon population O Families in low-rise social housing with high levels of benefit need 2% 0% 5% 10% 15% 20% 25% As would be expected in Devon, the largest groups in Devon are group A – Residents of isolated rural communities and B – Residents of small and mid sized towns with strong local roots.
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